the thoughts of a surgeon in the notorious province of mpumalanga, south africa. comments on the private and state sector. but mostly my personal journey through surgery.

Thursday, May 22, 2008

surgical ego

i don't know why surgeons have such inflated egos. maybe it's that the type of person that decides to do surgery is arrogant to start with. or maybe constantly being in a position where someone's life may hang in the balance based on your decision cultures a confidence which flows over into arrogance. whatever the reason i learned to read the ego of fellow colleagues and sometimes even swing things in my favour.

i was always short of money during training. towards the end this became much worse. i used to work in casualty units (er doctor) but when my prof found out that i was moonlighting he threatened to fire me. this door was closed and double bolted. he would only permit us to do private assistances.

so when one of the junior consultants asked me to assist him with a few private cases after a 36 hour shift with no sleep, i jumped at it. sleep be dammed. i needed the money. besides, assisting is a darn site better than casualty work.

the cases went well and i felt that i should be able to make ends meet with the amount of work i would get from assisting this surgeon. i was quite excited about it. but then, as life would have it, i got no more calls from him. once again my situation became tenuous.

then, out of the blue, he called me again. it seems his regular assistant was on call. it was my moment. but this time i knew i had to impress.

we started the operation. i did the usual things an assistant needs to do, but i watched every move he made carefully. i was looking for a way to get at his ego. then he did something that was ever so slightly better than mediocre. it was my chance.

"that was beautifully done! it is so great to assist you! i learn so much doing these assistances!" cheesy i know but i was desperate. besides it was also an interesting test to see if my theories about surgeons' egos were true. i was willing to be cheesy in the name of science. it was but a small sacrifice that i willingly made for the progress of knowledge.

and sure enough it worked. just a few choice words here and there so that the surgeon felt he was brilliant and i quickly became preferred assistant. i relied on that extra income and it made a great difference.

p.s although i had also done some great research, i unfortunately never published. somehow i just never got around to it.

13 comments:

I watched the whole 1st and 2nd series of Doc Martin (actor Martin Clunes) last weekend (don't ask!) and I couldn't help think of you always telling about the surgeons and their ego's. Funny stuff I tell you. If you ever have time on your hands (which I doubt), watch it.

I'm in the hospital today, sitting with a friend who is having a cervical fusion. We have a great surgeon(same one),albeit with a huge ego, and he did take one look at me just now and say, "Great! Now my day is totally ruined." (-:

Good job of turning a quirk into an advantage. I do agree that to be a surgeon one must have certain common characteristics; but I don't know why arrogance is so prevalent. It need not be. On the other hand, I wasn't (I don't think) arrogant, and I burned out fairly young. Maybe I needed more of it. You could be in trouble!

P.S: in preparing a related post, I came across this quote from one of my most influential mentors during training:

“And unfortunately the nasty thing about surgeons is, you have to have an ego tosurvive. ... when I talk to medical students, ... I say, as I introduce them to surgery,‘You may not like surgeons, as a whole we are not the most likable group ofindividuals. Now the thing that you may or may not perceive is that the surgeon hasan ego. And he has to have that ego to survive.’ Medicine is essentially a diagnosticspecialty. The medical guy gets his kicks out of diagnoses. Therapy is: ‘God did it. Iam going to help God make you better, if I can.’ All right. But you rarely cureanybody in medicine. In surgery you intervene directly into the patient's disease. Youplay God. And if you make the right decision and the patient does well you get a highand it's like nothing else. .... And on the other hand, if things go badly, you have alow. When your things go badly, as they will do, if you are involved in doing surgicalprocedures, how do you maintain your effectiveness if you think somebody else couldhave done it better? You are either amoral or conversely you believe in yourself. Andyou have got to have that belief to survive....And that creates a different type ofperson psychologically than the internist. The internist is a nice guy. He is often anintrovert. The surgeon is the extrovert.”F. W. Blaisdell, M.D

sid, i also don't think arrogance need be so common among us. however i do think confidence is often misconstrued as arrogance by non surgeons. if an anesthetist were to ask me he i was better than him at putting in a cvp i would say yes. he might misinterpret that as arrogance where i see it as simple fact.

richard, i think the introvert in you gets worked out to some extent. there is just too much forced human contact. but more importantly, what are we doing talking about psych issues on a surgical blog.:-)

dev, what an arsehole your (orthopedic) surgeon sounds. i hope you struck back with some comment about him not falling to well on the eye either.

Bongi, Fortunately my surgeon was completely kidding--he actually is very fond of me, and he and his wife are family friends, as our redheaded sons played together a decade ago. I was with my friend this morning, and I cheered up all the spinal patients showing them my tummy and back scars and assuring them they would be just fine.

Bongi: I'd love to hear about how surgeons protect their hands. I was shaking my surgeon's hand yesterday (usually he just hugs me, so I hadn't noticed before), and I couldn't believe how soft and smooth they were--like a baby's bottom, and he's about 57. I have to protect my voice, but not my hands.

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the aim of this blog is to give insight into the mind of a particular surgeon, me. although every story is loosely based on fact, patients have been changed suitably to protect their identity. the opinions expressed are mine alone and are not meant to be considered medical advice or the opinion of any institution.